<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label for="c-group_id" class="control-label col-xs-12 col-sm-2">{:__('Group')}:</label>
        <div class="col-xs-12 col-sm-4">
            <select class="form-control selectpicker" name="row[group_id]">
                <option value="3" selected="selected">代理</option>
            </select>
        </div>
    </div>

    <div class="form-group">
        <label for="c-username" class="control-label col-xs-12 col-sm-2">姓名（昵称）:</label>
        <div class="col-xs-12 col-sm-4">
            <input  data-rule="required" class="form-control" placeholder="姓名（昵称）" name="row[nickname]" type="text" value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-username" class="control-label col-xs-12 col-sm-2">{:__('Username')}:</label>
        <div class="col-xs-12 col-sm-4">
            <input id="c-username" data-rule="required" class="form-control" placeholder="用户名（登录账号）" name="row[username]" type="text" value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-password" class="control-label col-xs-12 col-sm-2">{:__('Password')}:</label>
        <div class="col-xs-12 col-sm-4">
            <input id="c-password" data-rule="password" type="password" class="form-control" name="row[password]" type="text" value="" placeholder="请填写密码" autocomplete="new-password" />
        </div>
    </div>

    <div class="form-group">
        <label for="c-password" class="control-label col-xs-12 col-sm-2">重复密码:</label>
        <div class="col-xs-12 col-sm-4">
            <input  data-rule="password" type="password" class="form-control" name="row[password_confirm]" type="text" value="" placeholder="请填写密码" autocomplete="new-password" />
        </div>
    </div>

    <div class="form-group">
        <label for="c-mobile" class="control-label col-xs-12 col-sm-2">手机号:</label>
        <div class="col-xs-12 col-sm-4">
            <input id="c-mobile" data-rule="" class="form-control"  name="row[mobile]" type="text" value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-mobile" class="control-label col-xs-12 col-sm-2">返点数:</label>
        <div class="col-xs-12 col-sm-4">
            <input  data-rule="required" class="form-control"  name="row[rebateNum]" type="text" value="">
        </div>
    </div>

    <div class="form-group">
        <label for="content" class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_radios('row[status]', ['normal'=>__('Normal'), 'hidden'=>__('Hidden')], 'normal')}
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
